Digestive System

1. Digestive System

2. Structure

3. Abdominal Quadrants

4. Abdominal Regions

5. Mouth • where the digestive process begins • consists of the tongue, salivary glands, teeth, and pharynx

6. Esophagus • A tube 10 to 12 inches long that carries food from the mouth to the stomach

7. Stomach • a hollow, muscular, J-shaped organ • holds food from 3 to 4 hours • has three parts: the fundus, body, and pylorus • produces gastric juices that help break down food

8. Intestines • the small intestine: where most of the food the body needs are absorbed into the bloodstream • the large intestine: where most water is absorbed, wastes are changed into solid form

9. Appendix • function is not known • attached to the cecum

10. Liver • The largest gland in the body • helps control the amount of protein and sugar in the body by changing and storing excess amounts

11. Gallbladder • a small hollow sac that is attached to the underside of the liver • it releases bile from the liver into the small intestine to help digest a fatty meal

12. Pancreas • located behind the stomach • aids in the digestion of food • produces insulin

13. Common Conditions of the Digestive System

14. Malignancies • very common • symptoms depend on location • indigestion • vomiting • constipation • obstruction • bloody stool

15. Ulcerations • a sore or tissue breakdown • common places: colon, stomach, duodenum

16. Hernias • the intestine pushes through a weakened area of the abdominal wall

17. Gallbladder Conditions • cholecystitis: inflammation of the gallbladder • cholelithiasis: formation of stones in the gallbladder

18. Common Problems Related to the Lower Bowel • diarrhea: multiple watery stools • constipation: when stool passes through the colon too slowly – most severe form: fecal impaction • bowel incontinence: involuntary passage of fecal material from the anus

19. Procedures Related to the Digestive System

20. Nasogastric Tube

21. NG Tube cont. • may be placed for stomach decompression (ex. – during CPR) • to give stomach rest • to relieve nausea

22. Normal CT of Abd

23. CT Scans • CTs may be done of abd/pelvis, with or without contrast (IV or PO) • used to diagnose abnormalities/conditions of digestive system

24. Esophagogastroduodenoscopy (EGD) • May be used to diagnose problems of the esophagus, stomach or duodenum • May be done in GI Lab at a Hospital as an outpatient

25. Nutrition • Food & fluids contain Nutrients-a substance the is taken in , digested, absorbed, and used by the body • Grouped into fats, proteins, carbohydrates, vitamins, minerals, and water (FPCVMW) • Which nutrients give the body fuel for energy? • FPC • Energy measured in calories • Food guide pyramid helps to guide healthy food choices-has 4 levels

26. Nutrients • Essential nutrients come from many different foods • Refer to basic information sheet about nutrition • Sometimes special diets needed to manage nutrition in patients

27. Fluid Balance • Water needed to live • Death can occur if there is too little or too much • Water is taken in through food and fluids • Water lost through elimination of urine and feces also through vomiting, perspiration and exhaling • To be healthy fluid balance is needed • Fluid taken in (intake) and lost (output) needs to be equal • Swelling (edema) occurs when more is taken in than put out • Dehydration occurs when more fluid is put out than taken in

28. Fluid Balance • Adults need to take in 1500 ml per day • For normal fluid balance about 2000-2500 ml is needed per day • Normal person can take fluid orally • Sometimes patients require special orders for fluids • Fluids may need to be encouraged to increase intake • Fluids may be restricted to a certain amount per day

29. Enteral Nutrition-Tubes • Nutrition given by gavage (tube feeding) • Different types of tubes • Nasogastric (NG) -inserted through the nose • Gastrostomy- inserted into the stomach through a surgically created opening • Jejunostomy – inserted in to small intestines through surgically created openint • Percutaneous endoscopic gastroostomy (PEG) Tube- inserted into the stomach with an endoscope and through a puncture wound made through the skin into the stomach

30. Enteral Nutrition-Formula • Formula ordered by doctor • Most contain all of the nutrients • Sometime may be made by the dietary department • Feedings may be continuous or scheduled at intervals • If they are continuous a pump is used to give the feeding • Scheduled feedings may be given with a syringe or tube feeding bag that allows feeding to drip

31. Enteral Feeding- Observations • Major risk is aspiration –which is breathing in of fluid or an object into the lungs • Aspiration can cause pneumonia and death • It is important to take measures to prevent aspiration • Nurse must regularly make sure tube is in the right place because tubes can move from coughing and sneezing or vomiting

32. Tube Feeding-Preventing Aspiration • X-ray may be taken after tube is inserted to verify placement • Nurse may check tube placement by aspirating gastric secretions • Prevent regurgetation by positioning patient in semi-Fowler’s Position –ask nurse of check care plan to find our how long • If there is a delay in stomach emptying can regurgitate feeding • Avoid left side lying position • Less of a problem with J-Tube

33. Observations for Patients receiving Tube Feedings • Observe and report immediately to nurse: • Nausea, vomiting • Diarrhea • Discomfort during tube feeding • Enlarged or swollen stomach • Elevated temperature • Redness, swelling, drainage • odor or pain at the insertion site • Difficulty breathing • Elevated pulse rate • Coughiing • Complaints of bloating or flatulence

34. Intravenous Therapy • This is giving fluids by way of a needle or catheter that has been inserted into a patient’s vein usually by an RN • May be given in various settings such as hospital, outpatient, doctor’s office, home care setting, long-term care setting • Requires a doctor’s order • Given to replace fluids, replace vitamins and minerals lost from illness or injury • Blood and blood products are given through IV

35. Intravenous Therapy Sites • Peripheral Sites- away from the center of the body • Sites may be in the hand, wrist, and antecubital space ( bend of elbow) • If site is an IV catheter or needle facility may allow PCT to discontinue • PCT must know how and have been delegated this responsibility by the RN before attempting to D/C an IV. • Central Venous

36. TPN • Provides total parenteral nutrition (TPN) also called Hyperalimentation to patients. • May be given through aperipheral • TPN contains all of the essential nutrients needed to sustain life, Fat may be added in the form of lipids

37. Specimen Collection Principles • Adhere to medical asepsis principles • Follow Standard Precautions • Use a clean or sterile container for each specimen • Use the right container for the specimen Label the specimen correctly • Avoid touching the inside of the container and lid • Urine must be free of feces • No tissue in urine and stool specimen • Place specimen in plastic bag • Specimen should be taken to lab promptly